Mediastinum
Thymic carcinoma
General

Author: Hanni Gulwani, M.D. (see Authors page)

Revised: 18 June 2018, last major update December 2012

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Thymic carcinoma[TI] general

Cite this page: Gulwani, H. Thymic carcinoma - general. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/mediastinumthymiccarcinoma.html. Accessed July 22nd, 2018.
Definition / general
  • By definition, has overt cellular anaplasia
Epidemiology
  • Ages 50+, occasionally children
Diagrams / tables

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Proposed stage T1, tumor limited to thymic gland

Proposed stage T2, tumor invades nearby structures

Proposed stage T3, direct (continuous) extrathoracic tumor extension beyond thoracic inlet or below diaphragm

Clinical features
  • Associated with hypercalcemia, elevated parathyroid hormone levels, pulmonary sarcoidosis
  • Not associated with paraneoplastic syndromes such as myasthenia gravis or pure red cell aplasia
  • Patients usually present with mass related symptoms
  • Aggressive clinical course
  • Must exclude other primaries, which are much more common (lung, trachea, bronchi, esophagus)
  • Usually squamous cell carcinoma and variants (lymphoepithelioma-like, basaloid)
  • Proposed staging system (Am J Clin Pathol 2012;138:115)
Prognostic factors
  • May be less aggressive than commonly believed; important prognostic factors are lymph node status and tumor size (Am J Clin Pathol 2012;138:103)
Gross description
  • Unencapsulated, no internal fibrous septation, firm / hard / gritty with gray-white cut surface, necrosis and hemorrhage
Microscopic (histologic) description
  • Usually cohesive cellular growth, regularly round / oval nuclear outlines, eosinophilic nucleoli, geographic necrosis
  • Usually foci of medullary differentiation, abortive Hassall corpuscles, rosettes, gland-like spaces, T lymphocytes; no perivascular spaces
  • Subtypes discussed as separate topics
Microscopic (histologic) images

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Various subtypes

Positive stains
Negative stains
Electron microscopy description
  • Well formed desmosome-like intercellular junctions, cytoplasmic tonofilaments that may insert into junctional complexes
Differential diagnosis